Returning to sport after anterior cruciate ligament reconstruction in amateur sports men: a retrospective study

Abstract

SummaryBackground: According to the literature, 95% of professional athletes return to their sport after anterior cruciate ligament (ACL) reconstruction surgery. The main objective of this study was to verify the return to sport after ACL reconstruction in a homogenous group of amateur sportsmen and sportswomen in a series of Italian patients. Materials and methods: We designed a retrospective study in which we analyzed the amateur sports patients operated for ACL reconstruction. We verified whether they had returned to sporting activities by comparing the pre-and post-operative Tegner activity scores. We then analyzed the average time to restart the sporting activity and the Lysholm and International Knee Documenting Committee (IKDC) scores. Results: We analyzed 80 subjects: 47.5% restarted a sports activity, on average after eight months, with a significant reduction of their competitive level or physical commitment, as expressed by the Tegner activity score (pre-operative: 6.9; post-operative: 3.9; p<0.01). The functional knee recovery was good, as expressed by the average score of the Lyshom Knee Scoring Scale (93.5) and the IKDC (74.7). Conclusions: In the literature, a return to sport for international case studies and amateur sports is higher than our data. In our population we found the lack of information provided by the medical staff at discharge and follow-up. The assessment at a short-term follow up allowed us to verify that at the end of the post-surgical rehabilitation program the patients were uninformed about the timing and the ability to resume a sporting activity. An efficacious relationship between orthopedic doctor, physiotherapist and a doctor in motorial science may ensure proper treatment the patient after ACL reconstruction. It is important to guarantee the restarting of the sports activity to have a better quality of life in amateur sports. Level of evidence: V.KEY WORDS: return to sport, soccer, knee, surgery, anterior cruciate ligament.

Fear of re-injury following ACL reconstruction: an overview

“…Notarnicola et al reported that 52.5% of their patients did not RTS, while there was no difference in the PROs between patients who achieved return and those who did not. Moreover, the pre-injury level of activity was restored only in a low percentage of patients, whereas most of them chose a less competitive sport 15 . The authors attributed this decline in sporting level mainly to fear of movement and reinjury 15 .…”

“…There is a consistent relationship between the self-confidence of the patient, his optimism and motivation to recover from the injury and the actual outcome of the operation 12,19 . Fear of re-injury might be more prominent in competitive athletes, as they take part in more aggressive and unsafe scenarios, during both training and professional games, predisposing them to injuries 15 .…”

Tripled semitendinosus with single harvesting is as effective but less invasive compared to standard gracilis-semitendinosus harvesting

“…Return to sport and activity level have been the same for both grafts. Nevertheless, the activity level was not always restored to the pre-injury level, like already reported in the literature [11][12][13] . In addition, these results suggested that the mean thickness of the two type of graft did not differ significantly.…”

Anterior cruciate ligament deficiency: rotational instability in the transverse plane. A preliminary laboratory in vivo study

“…ACL deficiency can lead to knee instability and secondary joint damage (2). The management of ACL deficiency aims to restore knee function, and subjective and functional outcomes of surgical treatment have been reported as good and excellent in up to 80% of patients, with sport return rates near to 50% in amateur patients (3,4). Therefore, a high percentage of patients may experience suboptimal outcomes after treatment.…”